“What’s the first word that pops up in your mind when you hear ‘cancer’?”
“Death.”
This is the answer given by 58% of participants in a US study when asked about their impression of cancer. Cancer is a disease that has been strongly associated with fatalism, causing fear among the majority of the population. This mindset is detrimental as it drives people away from all cancer-related topics, including important preventive or therapeutic strategies that greatly help reduce the risk of developing cancer — a risk that seems inevitable as we age.
As someone deeply interested in the underlying biology of cancer and dedicated to exploring potential cures, I want to emphasize that cancer is a topic that touches every one of us. More importantly, our fear can fade away if we understand what cancer is, how it develops, and why it occurs. At the end of the day, we will become courageous enough to directly face affront and fight against this nightmare.
Disclaimer: I am not a certified medical expert or licensed professional. The information in this article is drawn from my personal experience and research and is not intended to replace professional medical advice. Always consult a qualified healthcare provider before making any lifestyle changes, especially if you have pre-existing medical conditions.
What’s unique about cancer?
Unlike most of the “famous” diseases that are widespread and likely cause severe consequences to our life, the origin of cancer is more or less unique. Down to the small seasonal flu, and up to the middle-scale epidemic or global pandemic such as the modern “Titan” COVID-19, many of us eventually collapsed due to external attacks by specific bacteria or viruses. It makes sense, right? Much like how a weak country, unable to defend itself against a stronger adversary, collapses. We sympathize with the tragedy but also comprehend the underlying cause.
Cancer, however, is different. Instead of collapsing due to external attacks, the development of cancer is more like an internal decay.
When we hear that someone has cancer, it means that parts of their body that once functioned properly have somehow transformed to the evil monsters. These malignant entities start to attack the folks who were once their fellowmen, seek to dominate the surroundings, and even expand their colonization to other organs. Finally, the whole system crumbles and starves to death due to limitless exploitation of resources and space, leading to a lose-lose result. This internal betrayal is what makes cancer particularly shocking and challenging to treat. It’s akin to discovering that a trusted neighbor has suddenly turned into a harmful threat. Such nature is also one of the most fundamental forces that has driven so many researchers and scientists to dedicate their entire life into understanding this disease and solving this problem faced by our entire species.
What is Cancer?
To figure out the “why”, we have to know the “what”.
Cancer cells originate from normal cells that grow uncontrollably and spread to other parts of the body. Our bodies are made up of trillions of cells, each constantly growing, duplicating, and replacing old cells to keep us alive and vibrant. The basic process for cell duplication involves the replication of DNA, which carries genetic information that instructs how cells function. DNA acts like the government in a city, issuing general instructions to each department (which can be seen as the organs in our body) to ensure the whole city operates harmoniously. However, just as governments occasionally implement “inappropriate” policies that complicate our lives, errors can also arise during the process of DNA replication. These errors, known as mutations, are usually not fatal and can often be corrected by our body’s defense mechanisms.
One powerful defense measure is done by our immune system, where numerous immune cells serve as the “surveillance guards” who are diligent and responsible workers that constantly check for the presence of these errors. When detected, the mutated cells are quickly and effectively eliminated. Even more remarkable is that the cell itself carries “suicide switch,” which is activated by an overload of mutations or the emergence of fatal mutations. This process, called apoptosis, allows cells to self-destruct, preventing the spread of potential damage.
Similar to everything else in our lives, it is almost impossible to monitor and perfectly correct every existing or emerging error. When mutations are not corrected, they can quickly pile up in the cell, transforming it into a deformed and well-armored mega version that breaks all the conventional rules set by the body while trying to establish a new empire with its own laws. Initially, despite forming a large lump of tumor due to rapid proliferation, these cells are not yet life-threatening because they lack the ability to invade other territories. However, these cells become cancerous as time passes by, fighting for the limited resources and space with normal cells whilst expanding their colonization through a process called “metastasis.” Tumors at the initial stage are “benign,” known for their moderate threat and can often be cured with relative ease. In contrast, cancerous tumors are what we fear the most, as they are more likely to lead to death.
How has the good gone bad?
Like most of you, I hate to see the good turn bad. We want to preserve the good, just as we want to keep flowers blooming, fruit ripening, and our lives young and healthy. However, avoiding the problem is not the solution. We need to take the initiative, face the problem, and do our best to uncover the underlying “why” and “how” to come up with effective solution and reach a point where we no longer suffer from this nightmare.
Gene mutation is the “culprit”
So, how did the good turn bad? It is a strenuous process that takes years or even decades for mutations to accumulate within a cell and turn it cancerous. No one on Earth has fully comprehended this microevolutionary process, as it involves numerous intricate biological reactions and interactions. Don’t worry, we will not delve into the scientific details here, this article is not published in Nature or Science (not because it’s dull and boring and no one cares…).
Why do genes undergo mutations? Asking this question equates to asking some sort of fundamental philosophical questions like “Who am I, where am I, and why am I here?” Though very important, but extremely hard to give definitive answers. For now, the simplest answer to why cells undergo genetic mutations is: ‘Because no one is perfect,’ I say with a shrug. Just like us, cells make mistakes throughout their existence. The co-existence of good and bad might just be one of the inherent imperfections given to every living thing by nature.
How to minimize gene mutations?
It is impossible to not make mistakes, but it is very possible to minimize wrong decisions and improve ourselves to prevent them from happening. In addition to random genetic mutations, numerous external factors play important roles in whether these mutations will accumulate and/or turn cancerous. A well-known example is the relationship between smoking and lung cancer. I have heard more than once from senior men in my life, either my dad or his friends, that someone they know who had a nearly 30-year smoking history lived to over 90 years old, free from cancer. Such anecdote seems to justify their heavy smoking while making them laugh at those who genuinely care about their health.
Their claim is far from reasonable. First and foremost, legitimate scientific studies have established the causality between smoking and lung cancer, identifying more than 60 cancer-causing agents (“carcinogens”) in tobacco that drive DNA mutations. If you are not a science person, think of it this way: How can you base your cancer risk on someone else’s experience? Everyone’s body is different and should not be directly compared. At least we know statistically that less smoking reduces the risk of cancer. Why not start making changes now rather than regretting it later after receiving a diagnosis?
Where do we find the solution? Ourselves.
The solution to any problem should always come from two perspectives: prevention and treatment. Preventive strategies minimize the chance of encountering a problem, while therapeutic strategies optimize the potential for resolving it. The most relevant way to prevent cancer is through lifestyle changes, which are implemented in various aspects. Bear in mind the main goals: to reduce the occurrence of cancer-related gene mutations while boosting our immunity.
Prevention: what we should care the most
For example, if you have been a heavy smoker or drinker, aim to reduce the number of cigarettes or the amount of alcohol you consume, as we already know they contain many carcinogens that increase our risk of cancer. Since my dad is heavily dependent on smoking, consuming a whole pack of cigarettes per day, I absolutely understand how hard it is for someone to quit a habit developed over decades. You don’t have to quit entirely, but remind yourself to first, bear in mind that these substances that bring you momentary pleasure can cause long-term pain, suffering, and even early death; second, try to reduce the amount to half, then to one-third, and continue to decrease it over time. Changes in mentality and actions should be implemented simultaneously to complement each other. Once you develop the awareness that what you are doing is actually harming you, it is only a matter of time before you can say goodbye to these habits.
Boosting our immune system might sound fancy, but it can easily be achieved in daily life through consistent and regular intake of various fruits and vegetables. Since many people have already listed the foods that benefit immunity in detail, I won’t reiterate them here. Attention: enhancing immunity doesn’t have to be expensive at all! If you are not well-off, one apple, one orange, plus one banana on a regular basis is way enough. Indulge yourself with more diversity once or twice a week (FYI, I award myself tons of berries on the weekend for having regular and healthy “fruit” diet. I call it the “B-day”). Functional foods such as prebiotics and probiotics are such a hit now, but they are not 100% necessary.
Treatment: what the medical system should care the most
Therapeutic strategies should focus on boosting our immune system, which has fortunately been intensively investigated in recent decades. Unlike conventional cancer treatments such as chemotherapy and radiotherapy, immunotherapy — therapies that enhance our immune system — greatly increases targeting specificity against cancer cells while sparing normal ones. If you play video games like League of Legends, conventional therapies might make you stronger, but they also blind you to distinguishing teammates from enemies. At the end of the day, you become a powerful giant that kills everyone. That’s not how you want to win the game, right? Instead, you want something that makes you stronger only against the enemy, which is what immunotherapy will likely achieve. The significance of immunotherapies doesn’t stop there. Our ultimate goal is not to completely eliminate cancer but to achieve a balance between cancer and immunity using something like the immunotherapy, allowing us to coexist with cancer while keeping it under control.
